CHOOSE THE SINGLE BEST ANSWER
1.Benzodiazepines are used to manage all of the following conditions EXCEPT
A. general anxiety disorder
B. social phobia
C. post traumatic stress disorder
D. obsessive compulsive disorder
E. panic disorder
2. Some of the vasodilatory activity of ACE inhibitors is caused by
A. increased biosynthesis of bradykinin
B. decreased degradation of bradykinin
C. increased biosynthesis of angiotensinogen
D. decreased degradation of prostaglandins
E. decreased biosynthesis of catecholamines
3. An adverse effect of olanzepine is
A. agranulocytosis
B. seizures
C. gynecomastia
D. hypertension
E. weight gain
4. Probenecid may be combined with penicillin to treat gonorrhea because it
A. decreases hepatic degradation of penicillin
B. increases the potency of penicillin
C. increases renal reabsorption of penicillin
D. decreases renal secretion of penicillin
E. increases metabolic activation of penicillin
5. Losartan is useful as monotherapy to treat hypertension because it blocks
A. the production of angiotensinogen
B. the production of angiotensin II
C. the degradation of renin
D. the AT-1 receptor
E. α1 -adreno receptors
6. Long term repeated exposure to which of the following anesthetics has been linked with
neurologic signs and symptoms resulting from Vitamin B12 deficiency?
A. Fentanyl
B. Halothane
C. Ketamine
D. Nitrous oxide
E. Propofol
Matching. From the following list select the drug that best matches each statement
below. Each drug may be used once, more than once or not at all.
A. Beclomethasone
B. Methylprednisolone
C. Dextromethorphane
D. Ipratropium
E. Guaifenesin
7. _____ Stimulates secretions of the respiratory tract epithelium.
8. _____ Suppresses cough due to its actions within the central nervous system.
9. _____ A muscarinic cholinergic receptor antagonist useful in the treatment of
asthma and allergic rhinitis.
CHOOSE THE SINGLE BEST ANSWER
The following scenario applies to the next three questions:
A patient previously diagnosed with mild intermittent asthma opted to treat himself with
an over-the-counter inhaler containing epinephrine for quick relief of his attacks. He
now comes to you because recently his asthma attacks are becoming more frequent,
but not more severe, and he has noticed that he must use more and more of the inhaler
to abort an attack. When used in this manner, he notices that his heart rate increases
markedly.
10. The reason he has to use greater amounts of the inhaler is most likely due to
A. decreased airway absorption of epinephrine
B. increased local metabolism of epinephrine
C. down regulation of airway smooth muscle beta adrenergic receptors
D. upregulation of phosphodiesterase in airway smooth muscle
11. An alternative quick-relief drug with lower tendency to cause an increase in heart rate is
A. salmeterol
B. terbutaline
C. isoproterenol
D. zileuton
E. theophylline
12. Each of the following could be a useful addition as a drug for long-term control of his
asthma EXCEPT
A. nedocromil
B. beclomethasone
C. omalizumab
D. montelukast
E. isoproterenol
Matching. From the following list, select the enzyme inhibited by each agent listed
below. Each enzyme may be used once, more than once or not at all.
A. tyrosine hydroxylase
B. inositol monophosphatase (IMPase)
C. monoamine oxidase (MAO)
D. catechol-o-methyltransferase (COMT)
13. _____ Entacapone
14. _____ Selegiline
15. _____ Nicotine
16. _____ Lithium
17. A patient has a seizure disorder that is localized to one hemisphere of the brain. The
attacks last about one minute, she does not lose consciousness, and she experiences
contractions of muscles on one side of her body. Her seizure is best treated with
A. vaiproic acid
B. ethosuximide
C. lorazepam
D. carbamazepine
18. MAC values for inhalation anesthetics will increase
A. with increasing age
B. following premedication with benzodiazepines 1
C. following chronic alcohol abuse
D. with decreasing weight of the patient
E. with impaired kidney function
19. In contrast to paroxetine, phenelzine
A. has a more rapid onset of therapeutic action
B. is a more effective agent for depression
C. blocks reuptake of serotonin
D. causes hypotension
E. causes sexual dysfunction
20. Which of the following sensitizes the myocardium to catecholamines, toereby increasing
the risk of excessive cardiac stimulation and, thus, arrhythmias?
A. Fentanyl
B. Halothane
C. Ketamine
D. Nitrous oxide
E. Propofol
21. Tolerance develops to all of the following effects of the benzodiazepines EXCEPT their
A. muscle relaxant activity
B. hypnotic activity
C. anxiolytic activity
D. anticonvulsant activity
22. Tricyclic antidepressants like imipramine may cause
A. elevation of seizure threshold
B. miosis
C. hypertensive crisis
D. priaprism
E. tremor
23. Lysine vasopressin acts by increasing
A. glomerular filtration rate
B. renal perfusion pressure
C. water and sodium reabsorption in the proximal tubule
D. water permeability in the collecting duct
E. renal filtration fraction
24. At a dose that is usually adequate for relief of pain, you discover that morphine causes
a specific adverse effect that is related to each of the conditions listed below. For which
condition might it be appropriate to use a higher than usual dose of morphine?
A. Pregnancy
B. Hypovolemia
C. Kidney stones
D. Emphysema
E. Benign prostatic hypertrophy
25. A patient administered meperidine for emergency pain management developed
tachycardia, severe hypertension, and hyperpyrexia. He was discovered to be taking
an antidepressant. Which of the following drugs was most likely responsible for the
adverse drug-drug interaction?
A. Lithium
B. Phenelzine
C. Zolpidem
D. Valproic acid
E. Haloperidol
26. The second gas effect will be of practical importance with which of the following pair of
anesthetics?
A. Halothane and Sevoflurane
B. Nitrous oxide and Isoflurane
C. Halothane and Isoflurane
D. Nitrous oxide and Thiopental
E. Isoflurane and Diazepam
27. All of the following benzodiazepines are metabolized to an active, long- acting (up to 96
hrs) agent EXCEPT
A. chiodiazepoxide
B. lorazepam
C. diazepam
D. chlorazepate
E. zolpidem
28. Agonist activity of ADH acts at V2 receptors to
A. increase aldosterone biosynthesis
B. cause vasoconstriction
C. cause vasodilation
D. increase aquaporin biosynthesis
E. increase salt appetite
For the following 2 questions, pick the correct choice from the list below
A. Na+-K+-ATPase
B. ENaC (collecting tubule Na+ channel)
C. NCC (Na+-Cl- cotransporter)
D. NKCC2 (Na+-K+-2Cl- cotransporter)
E. Na+-K+ exchanger
29. _____ Molecular target of furosemide.
30. _____ Blocked by triamterene
Matching. From the following list select the drug that best matches each statement
below. Each drug may be used once, more than once, or not at all.
A. Amitryptyline
B. Sumatriptan
C. Ergotamine
D. Methylsergide
E. Propranolol
31. _____ A relatively selective serotonin 5-HT1(D) agonist used for acute abortive
management of a migraine headache.
32. _____ Severe nausea and strong peripheral vasoconstriction are hallmarks of
this drug used to abort a migraine headache.
33. _____ Used as a prophylactic agent to prevent a migraine headache, this drug is
useful for patients with coexisting hypertension.
Matching. From the following list select the drug that best matches each statement
below. Each drug may be used once, more than once or not at all.
A. Thiopental
B. Morphine
C. Haloperidol
D. Propranolol
E. Phenytoin
34. _____ Its short duration of action following a single dose is due to its
redistribution from the CNS to other tissues
35. _____ Tardive dyskinesia is a major limiting adverse effect of this drug
36. _____ Used to reduce the autonomic symptoms of anxiety
Two inhaled general anesthetics, X and Y have the following MAC values
X. MAC=1.0%
Y. MAC=6.0%
37. Based on this information and ONLY this information, which is TRUE?
A. Drug Y causes greater analgesia and skeletal muscle relaxation than DrugX.
B. The concentration of drug in inspired air that is needed to cause adequate
surgical anesthesia is higher for Drug Y than for Drug X.
C. The time of onset of general anesthesia is 6 times longer for Drug X than
for Drug Y.
D. Drug X undergoes more metabolism than Drug Y.
E. Drug X and Drug Y should not be used in combination.
38. In contrast to amphetamine, cocaine
A. has a short duration of action
B. can be self-administered by smoking
C. results in a high degree of tolerance when used chronically
D. causes cirrhosis of the liver
E. causes gastrointestinal necrosis (necrotizing arteritis)
39. Eplerenone acts as a specific
A. antagonist of the mineralocorticoid receptor
B. antagonist of the renin receptor
C. agonist of the AT2 receptor
D. agonist of the ADH V1 receptor
E. antagonist of the NCC co-transporter
40. In contrast to tricyclic antidepressants (TCA), selective serotonin reuptake inhibitors
(SSRI) like fluoxetine may cause
A. excitation
B. hypertension
C. cardiac arrhythmias
D. sexual dysfunction
E. constipation
41. Which of the following drugs induces a copious paradoxical salivation, particularly
during sleep?
A. Fluphenazine
B. Imipramine
C. Clozapine
D. Lithium
E. Haloperidol
42. A patient with bipolar disorder has been effectively managed with lithium for 16 months.
Which of the following drugs or conditions could reduce the therapeutic effectiveness of
lithium?
A. Thiazide diuretics
B. High salt diet
C. Vomiting
D. Excessive sweating
E. Acetaminophen
43. A major limiting adverse effect of alprazolam when used longer than 4 -6 weeks to treat
anxiety is
A. tardive dyskinesia
B. physical dependence
C. neuroleptic malignant syndrome
D. aplastic anemia
44. In contrast to an amide local anesthetic with a pKa of 7.9, an amide local anesthetic with
a pKa of 8.4 would be expected to have
A. decreased efficacy
B. increased potency
C. reduced therapeutic index
D. decreased plasma protein binding
E. increased efficacy as an anti-arrhythmic agent
45. Akathisia can be effectively managed with
A. pilocarpine
B. valproic acid
C. l-dopa
D. propranolol
E. thiamine
46. In contrast to phenytoin, valproic acid causes
A. significant weight gain
B. hirsuitism
C. fetal malformations
D. life-threatening dermatological reactions
E. induction of its own metabolism
47. Which of the following is used to prevent development of local anesthetic-induced
seizures?
A. 3% carbon dioxide
B. diazepam
C. succinylcholine
D. epinephrine
E. thiopental
48. Marijuana may cause
A. miosis
B. increased ability to concentrate
C. decreased appetite
D. increased intraocular pressure
E. tachycardia
49. A male patient who has recently survived a major myocardial infarction with some loss
of myocardial function needs to be treated for grade 1 hypertension upon discharge.
Which of the following would be the best choice to treat his hypertension and reduce the
risk of a second infarction?
A. Verapamil
B. Nifedipine
C. Spironolactone
D. Losartan
E. Proprarnolol
50. Ataxia, nystagmus, anterograde amnesia, confusion, and confabulation are symptomsof
A. withdrawal from heroin
B. chronic alcohol abuse
C. amphetamine overdose
D. chronic heavy smoking
E. methanol toxicity
51. Allopurinol is used to prevent gout because it
A. inhibits the production of prostaglandins
B. increases urate excretion
C. decreases urate biosynthesis
D. inhibits leukocyte migration
E. increases urate solubility
52. Following an intravenous overdose of cocaine during a "spree" one might expect all of
the following symptoms EXCEPT
A. seizures
B. myocardial infarct
C. paranoia and hallucinations
D. bradycardia
E. hyperthermia
53. In contrast to a male of Norwegian descent, a male of Chinese descent is more likely to
A. have a lower plasma alcohol concentration after consuming one 12 oz.
beer
B. avoid alcohol
C. develop malignant hyperthermia immediately after consuming one 12 oz.
beer
D. become "addicted"
54. A diabetic patient with 3+ protein in her urine enters your hypertension clinic and has a
blood pressure of 157/102 mmHg. Which of the following would be the best choice to
treat the hypertension in this patient?
A. Enalapril
B. Nifedipine
C. Hydrochlorothiazide
D. Furosemide
E. Propranolol
55. Activation of presynaptic opioid mu-receptors inhibits neuronal cell entry of which of the
following ions?
A. Chloride (Cl-)
B. Calcium (Ca 2+)
C. Sodium (Na+)
D. Potassium (K+)
E. Lithium (Li+)
56. The highest risk of malignant hyperthermia is associated with coadministration of
succinylcholine and
A. Nitrous oxide
B. Propofol
C. Ketamine
D. Halothane
E. Midazolam
57. Which of the following would be most appropriate for treating a patient with central
diabetes insipidus?
A. Insulin
B. Hydrochlorothiazide
C. Desmopressin
D. Demeclocycline
E. Aldosterone
58. An adverse effect associated with the rapid intravenous administration of fentanyl is
A. diarrhea
B. cardiac depression
C. anesthesia
D. truncal rigidity
E. hyperalgesia
59. All of the following drugs are useful in the treatment of both asthma and allergic rhinitis
EXCEPT
A. phenylephrine
B. epinephrine
C. budesonide
D. cromolyn
Matching. From the following list select the drug that best matches each statement
below. Each drug may be used once, more than once or not at all.
A. L-dopa
B. Zolpidem
C. Buspirone
D. Morphine
E. Pramipexele
60. _____ Serotonin 5-HT1-receptor agonist
61. _____ Benzodiazepine BZ1-receptor agonist
62. _____ Dopamine D2-receptor agonist
63. _____ A cancer patient develops life-threatening hypercalcemia. Which of the following would
be the best to treat this condition?
A. Furosemide
B. Hydrochlorothiazide
C. Metazolone
D. Captopril
E. Desmopressin
64. Which of the following drugs would be most likely to inhibit the metabolism of
carbamazepine?
A. Diazepam
B. Valproic acid
C. Phenytoin
D. Ethosuximide
65. Which of the following opioids has antidiarrheal activity, no significant analgesic activity,
and is administered together with atropine to discourage its abuse?
A. Dextromethorphan
B. Codeine
C. Diphenoxylate
D. Loperamide
E. Buprenorphine
66. Uricosuric agents
A. increase glomerular filtration of urate
B. decrease biosynthesis of purines
C. decrease renal reabsorption of urate
D. increase purine degradation
E. increase renal permeability of urate
67. Tolerance develops to all of the following effects of morphine EXCEPT
A. respiratory depression
B. sedation
C. constipation
D. euphoria
E. cough suppression
68. Which of the following statements characterizes the actions of amide local anesthetics?
A. high therapeutic index
B. limited distribution
C. significant first-pass metabolism
D. high incidence of allergenicity
Answers
1 / D / 45 / D2 / B / 46 / A
3 / E / 47 / B
4 / D / 48 / E
5 / D / 49 / D
6 / D / 50 / B
7 / E / 51 / C
8 / C / 52 / D
9 / D / 53 / B
10 / . C / 54 / A
11 / . B / 55 / B
12 / . E / 56 / D
13 / . D / 57 / C
14 / . C / 58 / D
15 / . C / 59 / A
16 / . B / 60 / C
17 / . D / 61 / B
18 / . C / 62 / E
19 / . D / 63 / A
20 / . B / 64 / B
21 / . C / 65 / C
22 / . E / 66 / C
23 / . D / 67 / C
24 / . C / 68 / C
25 / . B
26 / . B
27 / . B
28 / . D
29 / . D
30 / . B
31 / . B
32 / . C
33 / . E
34 / . A
35 / . C
36 / . D
37 / . B
38 / . A
39 / . A
40 / . A
41 / . C
42 / . B
43 / . B
44 / . D
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